ABSTRACT
For many years there has been controversy concerning the role of genetic influences in the pathogenesis of age-related macular disease. It is widely believed that the lesions causing visual loss occur in response to age-related changes in Bruch's membrane which are recognised clinically as drusen. In this study the density, size, and confluence of drusen as shown on colour photographs were compared in eyes of 50 spouses and 53 sibling pairs ascertained during a prospective study of age-related macular disease. Concordance between pairs of drusen--number, size, and density-were determined by kappa statistic and chi 2 test for trend. Drusen were absent in one sibling and 26 spouses of patients. There was a trend towards concordance of drusen characteristics between siblings but not between spouses, although the difference achieved 5% significance only for the number and density of drusen in the central macula. The difference of concordance between the probands and spouses and the probands and siblings was significant for all characteristics. These findings support the belief that genetic factors influence age-related changes in Bruch's membrane. They also imply that environmental factors are less important or alternatively that the environmental variation between households included in our study was not great enough to be evident.
Subject(s)
Aging/pathology , Bruch Membrane/pathology , Macular Degeneration/pathology , Aged , Aged, 80 and over , Environmental Exposure , Family Health , Female , Humans , Macular Degeneration/etiology , Male , Middle Aged , Prospective Studies , Sex FactorsABSTRACT
Break-up time and lissamine green epithelial damage were re-investigated among 90 office workers after six months in 60 and after one year in 73. There was fairly good correlation with a rank correlation of about 0.40 between both break-up time and lissamine green staining epithelial damage at the initial investigation and at the two re-investigations. All correlations were found highly statistically significant. The results indicate that the manifestation of dry eyes in office workers to a great extent is chronic and without seasonal variation, at least as long as the subject remains in the office environment.
Subject(s)
Air Pollution, Indoor , Conjunctiva/pathology , Dry Eye Syndromes/diagnosis , Lissamine Green Dyes , Occupational Diseases/diagnosis , Air Pollutants, Occupational , Chronic Disease , Epithelium/pathology , Follow-Up Studies , Humans , Tears/physiologyABSTRACT
Prolonged choroidal filling on fluorescein angiography in age-related macular degeneration is thought to indicate diffuse thickening of Bruch's membrane. To test the importance of this clinical sign, we reviewed the evolution of disease in eyes of patients with good visual acuity and a readable transit phase of fluorescein angiography at the time of recruitment into a longitudinal study of age-related macular degeneration. Ninety-six eyes satisfied these criteria. Of the 32 eyes with prolonged choroidal filling, 12 (38%) lost two or more lines, of visual acuity by two years, whereas only nine of 64 (14%) eyes with normal choroidal filling did so. The difference was caused by the higher incidence of geographic atrophy in the first group. The proportion of eyes that developed subretinal neovascularization was the same in the two groups, and no pigment epithelial detachments occurred. These findings indicate that this clinical sign has implications concerning visual prognosis in age-related macular degeneration.
